Replies to post #249382 on Biotech Values

[Fred Kadiddlehopper]

Wow, I did not know about the loss of muscle mass.

[Mufaso]

It is not just GLP-1 one drugs that cause muscle mass loss to be a problem. When you lose weight by any method (e.g. caloric deficit, bariatric surgery etc.) you will lose both muscle as well as fat. Exercise and dietary choices while losing weight (protein) can lessen the effect of muscle loss but the reality is that anytime you lose weight you will lose both fat and muscle in some proportion. The result is that your lean body increases, which I would argue is a good thing.

Here is an article from NBC along with several quotes:

Weight loss drugs can lead to muscle loss, too. Is that a bad thing?
https://www.nbcnews.com/health/health-news/weight-loss-drugs-muscle-loss-rcna84936

"When we look at weight reduction from any intervention, about one-third of the weight we lose tends to be lean mass, and that can be problematic,” said Dr. Jaime Almandoz, an associate professor of internal medicine in the Division of Endocrinology at UT”

… “That’s why we try to emphasize slow, consistent weight loss rather than quick weight loss, where you’re more likely to pull from your energy stores” in muscle, said Dr. Jonathan Purnell, an endocrinologist and professor of medicine at the Oregon Health and Science University Knight Cardiovascular Institute in Portland. Purnell has done consulting work for Novo Nordisk, according to the Centers for Medicare & Medicaid Services.

“It’s also a function of how low you go,” he said. “Once you enter into the healthy BMI range, you’re more likely to be pulling from the lean stores.”

Despite concerns about muscle mass loss, at the end of the dramatic weight loss period, people may actually have a healthier body composition, that is, the ratio of lean mass — especially muscle —compared to fat.

On ways to not lose too much muscle mass:

There are ways to mitigate lean mass loss during weight loss ...said Dr. Juliana Simonetti, co-director of the Comprehensive Weight Management Program at the University of Utah in Salt Lake City.

...One way is to make sure you’re eating enough protein, which can be difficult to do while using weight loss drugs. Protein is the building block of muscle; without enough of it, muscles aren’t able to build and repair themselves

...Exercise, specifically resistance training, is also a critical part of maintaining muscle mass during weight loss, she said.

[Mufaso]

Dew- I’m not certain that Mounjaro is worse than Wegovy/Ozempic when it comes to muscle loss.

That’s because these drugs (Mounjaro more so than Ozempic) cause loss of lean muscle mass as well as fat.

From the same article I reference in my previous post:
https://www.nbcnews.com/health/health-news/weight-loss-drugs-muscle-loss-rcna84936

Here is some data in the article from the Wegovy trial saying 40% of the weight loss was Muscle mass.

A 2021 clinical trial that tested the weight loss effects of Wegovy found that while about 40% of the weight people lost tended to be lean mass, including muscle, at the end of 68 weeks, people who took the drug had a lower risk of heart disease and better physical function compared to a placebo group.

Here is some data from a Mounjaro trial saying the muscle loss was only 25%:

Studies showed similar results for the drug tirzepatide, which is sold under the brand name Mounjaro. In a phase 3 clinical trial, “a reduction in lean mass was reported at a similar rate as what is seen in lifestyle-based treatments for obesity,” Jessica Thompson, a spokesperson for tirzepatide-maker Eli Lilly, said in an emailed statement.

Note that the article said that weight reduction from any intervention was about one-third of the weight we lost was lean mass making Mounjaro possibly better than old fashioned dieting in this regard.

A new analysis of data from the same trial found that after 72 weeks of taking the drug, about 25% of the weight participants lost was lean mass. However, the participants had an overall healthier body composition. Aronne, who worked on the trial, presented the findings this week at the European Congress on Obesity in Dublin

Disclaimers about the follies of comparing deferent trials aside, I would be very interested in any data you have that shows that semiglutide is better than tirzepatide for muscle mass retention or any other thoughts you have here.